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Licensing details for: 226

Name: ESTACIO, DANIEL TORIBIO

License Type: Pediatric Minimal Sedation Permit

Primary Status: Current - Active

Practice Location

1140 E. CHEVY CHASE DR.
GLENDALE CA 91205
LOS ANGELES county
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Issuance Date

December 15, 2023

Expiration Date

August 31, 2026

Current Date / Time

June 6, 2025
7:6:50 PM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: VINELAND FAMILY DENTAL GROUP, ESCUTIN & ESTACIO,

License/Registration Type: Fictitious Name Permit

License Number: 4522 Primary Status: Cancelled

Address :
8052 VINELAND AVE, STE 109
SUN VALLEY CA 91352
LOS ANGELES COUNTY

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PMS to DDS or OMS or SP

License/Registration Role: Pediatric Minimal Sedation Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: ESTACIO, DANIEL TORIBIO

License/Registration Type: Dentist License

License Number: 47886 Primary Status: Current - Active

Address :
27310 ROSE MALLOW LN
SANTA CLARITA CA 91387
LOS ANGELES COUNTY

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